Although the etiology of lupus is unknown, it is thought that hormonal, environmental and genetic factors may all be implicated. Hormonal influences seem to play a key role in disease development and progression. Beyond the increased incidence in women, several studies have noted alterations in estrogen and androgen metabolism occurring in patients with lupus. Decreased levels of androgens (androstenedione, DHEA, DHEA sulfate and testosterone) have been observed in female lupus patients, especially in those with active disease. This provides a rational basis for an open label, multicenter study of DHEA supplementation on inpatients with systemic lupus erythematosus.